Provider Demographics
NPI:1851691331
Name:BUCHANAN, PATRICIA RAYE (RPH)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:RAYE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 ROCK BARN RD
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-9474
Mailing Address - Country:US
Mailing Address - Phone:775-846-3473
Mailing Address - Fax:530-647-7454
Practice Address - Street 1:6498 PONY EXPRESS TRL
Practice Address - Street 2:
Practice Address - City:POLLOCK PINES
Practice Address - State:CA
Practice Address - Zip Code:95726-9604
Practice Address - Country:US
Practice Address - Phone:530-647-7449
Practice Address - Fax:530-647-7454
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist